Individual
KELLIANNE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
249 VIRGINIA AVE, JERSEY CITY, NJ 07304-1423
(201) 798-2165
Mailing address
249 VIRGINIA AVE, JERSEY CITY, NJ 07304-1423
(201) 798-2165
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05990400
NJ
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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